The adventitia is routinely removed from small arteries before the anastomosis, but the microcirculatory response to this maneuver has not been documented. We have used a rat cremaster muscle flap model for intravital microscopy to compare at the microcirculatory level the effect of blunt (n = 18) and sharp (n = 18) adventitial removal with unmanipulated control arteries (n = 18). Blunt stripping resulted in transient but significant reductions in the red cell velocity (50%, p < 0.05) and capillary perfusion (91%, p < 0.05). Sharp dissection did not affect red cell velocity; however, capillary perfusion was transiently reduced by 25% (p < 0.05). In this study, sharp adventitial dissection was found to be a less harmful method of small arteries preparation for microvascular anastomosis.